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Features of respiratory syncytial virus infection in children in the post-COVID 19 era 后COVID-19时代儿童呼吸道合胞病毒感染的特征
Q4 Immunology and Microbiology Pub Date : 2023-03-31 DOI: 10.37897/rjid.2023.1.2
G. Jugulete, M. Merișescu, Bianca Borcoș, M. Luminos
Respiratory syncytial virus (RSV) infection in children is a major public health problem, especially in the 0-1 year age group where clinical forms of the disease can evolve severely with life-threatening complications. In the period 2020 – 2022, as a result of epidemiological measures specific to the COVI-19 pandemic (protective mask, online teaching activity, social distancing) we have witnessed a considerable decrease in the number of cases of RSV infection in children. With the lifting of prophylactic measures and the onset of the cold season, we have seen an increase in the number of admissions with a diagnosis of respiratory virus in pediatric wards. In this article, we aim to analyze the clinical, evolutionary and epidemiological features of respiratory syncytial virus infection in children in the 2022 - 2023 season. We conducted a retrospective clinical study of RSV infection cases admitted to the Pediatric Infectious Diseases Clinical Departments of the National Institute of Infectious Diseases “Prof. Dr. Matei Bals” in the period October 2022 - March 2023. During this period, we registered 195 cases of RSV infection in children, which represents 6.47% of the total number of hospitalized virologic illnesses in children (195/3012). All pediatric RSV infection cases admitted to our wards have progressed favorably; we have not recorded any deaths. From an epidemiological point of view, the peak incidence of RSV infection in children occurred in December (98 cases). The most frequent clinical form of the disease was the medium form, but severe forms represented 31.8%. Among the complications, the most common were respiratory (acute respiratory failure, pneumonia/bronchopneumonia), hematological (intrainfectious and deficiency anemia, leukopenia, thrombocytopenia), digestive (diarrheal disease, hepatic cytolysis syndrome) and acute dehydration syndrome associated with hydro electrolytic and acid-base disturbances. Severe complications were more frequent than in previous seasons, being associated with a risk of an unfavorable outcome: acute respiratory failure and neurological complications (convulsions, encephalitis). We also observed that acute RSV infection in the 2022 - 2023 season is characterized by the association of co-infections (viral, bacterial and fungal) more frequent than in previous years (22.5%). The most frequent co-infections were bacterial (superinfections - pneumonia/bronchopneumonia) probably due to the immunosuppression of the hosts as a result of repeated recent episodes of viral infections. Of note, RSV infection associated with other coinfections evolved more severely, with prolonged hospitalization and more complications. In conclusion we can say that RSV infection in the 2022 - 2023 season evolved more severely in children compared to previous seasons because in the last 3 years during the COVID-19 pandemic there were very few cases of respiratory viroids, thus the population was not naturally immunized, especially t
儿童呼吸道合胞病毒(RSV)感染是一个主要的公共卫生问题,尤其是在0-1岁年龄组,这种疾病的临床形式可能会严重发展,并伴有危及生命的并发症。在2020-2022年期间,由于针对新冠肺炎疫情采取的流行病学措施(防护口罩、在线教学活动、保持社交距离),我们看到儿童呼吸道合胞病毒感染病例数量大幅下降。随着预防措施的解除和寒冷季节的到来,我们看到儿科病房中被诊断为呼吸道病毒的入院人数有所增加。本文旨在分析2022-2023年儿童呼吸道合胞病毒感染的临床、进化和流行病学特征。我们对2022年10月至2023年3月期间入住国家传染病研究所儿科传染病临床部的呼吸道合胞病毒感染病例“Matei Bals教授博士”进行了回顾性临床研究。在此期间,我们登记了195例儿童呼吸道合胞病毒感染病例,占儿童住院病毒学疾病总数(195/3012)的6.47%。我们病房收治的所有儿童呼吸道合胞病毒感染病例进展顺利;我们没有任何死亡记录。从流行病学角度来看,儿童呼吸道合胞病毒感染的高峰发生在12月(98例)。该疾病最常见的临床形式是中度,但严重形式占31.8%。在并发症中,最常见的是呼吸系统(急性呼吸衰竭、肺炎/支气管肺炎)、血液系统(感染内和缺乏性贫血、白细胞减少症、血小板减少症),消化系统(腹泻病、肝细胞溶解综合征)和与水电解和酸碱紊乱相关的急性脱水综合征。严重并发症比前几个季节更频繁,与不良后果的风险相关:急性呼吸衰竭和神经系统并发症(抽搐、脑炎)。我们还观察到,2022年至2023年季节的急性呼吸道合胞病毒感染的特点是合并感染(病毒、细菌和真菌)比往年(22.5%)更频繁。最常见的合并感染是细菌(重叠感染-肺炎/支气管肺炎),可能是由于最近反复发作的病毒导致宿主免疫抑制传染值得注意的是,与其他合并感染相关的呼吸道合胞病毒感染发展得更严重,住院时间更长,并发症更多。总之,我们可以说,与前几个季节相比,2022年至2023年季节的呼吸道合胞病毒感染在儿童中进化得更严重,因为在新冠肺炎大流行的过去3年中,呼吸道类病毒病例非常少,因此人群没有自然免疫,尤其是0至4岁年龄组。此外,放弃对呼吸道疾病的具体保护措施,使儿科人群,尤其是儿童的呼吸道疾病数量“激增”。
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引用次数: 0
Meningo encephalitis with Epstein-Barr virus in an immunocompetent adult patient: case report 一例免疫功能正常的成人患者伴有eb病毒的脑膜脑炎
Q4 Immunology and Microbiology Pub Date : 2023-03-31 DOI: 10.37897/rjid.2023.1.3
Sabina-Lucia Ganea, M. Arbune, Daniela-Renata Santea, Catalina-Elena Radu, A. Arbune
Epstein - Barr virus is a rare ethology of the neurological infections, expressed as encephalitis, aseptic meningitis, Guillain-Barre syndrome or acute demyelinating encephalomyelitis. Most common cases were reported in children, while this infection is rarely described in immunocompetent adults. We present the case of an elderly immunocompetent patient with hypertension and hypothyroidism under treatment who has presented to the emergency department for unusual headache, confusion, sudden loss of consciousness with retrograde amnesia, suddenly onset for 2 hours associated with febrile respiratory symptoms. Traumatic neurological events, cerebral ischemia or metabolic encephalopathies were ruled out, while examination of the cerebrospinal fluid was positive for Epstein Barr Virus. The course of the meningoencephalitis was favorable, although an episode of diarrhea with Clostridioides difficile with binary positive toxin A+B was notified. The primary infection or the reactivation of a previous infection, is a questionable mechanism of meningoencephalitis with Epstein Barr Virus in an old immunocompetent patient. According to the reported studies, the antiviral treatment with Acyclovir is controversial. The long-term prognosis of acute meningoencephalitis with Epstein Barr Virus is unpredictable and involves careful neurological and onco-hematological monitoring.
Epstein -Barr病毒是一种罕见的神经系统感染,表现为脑炎、无菌性脑膜炎、格林-巴利综合征或急性脱髓鞘性脑脊髓炎。大多数常见病例报告在儿童中,而这种感染很少描述免疫正常的成年人。我们报告一例正在接受治疗的老年免疫功能正常的高血压和甲状腺功能减退患者,他以不寻常的头痛、神志不清、突然意识丧失并逆行性遗忘,突然发作2小时并伴有发热呼吸道症状就诊于急诊科。排除了创伤性神经系统事件、脑缺血或代谢性脑病,脑脊液检查呈eb病毒阳性。脑膜脑炎的病程是有利的,尽管报告了艰难梭菌双阳性毒素A+B腹泻的发作。原发性感染或先前感染的再激活是老年免疫功能正常患者发生eb病毒脑膜脑炎的一个值得怀疑的机制。根据报道的研究,阿昔洛韦的抗病毒治疗是有争议的。感染eb病毒的急性脑膜脑炎的长期预后是不可预测的,需要仔细的神经和肿瘤血液学监测。
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引用次数: 1
Mechanism of biofilm formation in ESKAPE organism and their treatment ESKAPE生物膜形成机制及其处理
Q4 Immunology and Microbiology Pub Date : 2022-12-31 DOI: 10.37897/rjid.2022.4.3
Apoorva Jain, P. K. Javaregowda, Kelmani Chandrakanth R, A. Oli
One of the major global issues is the urgency of nosocomial infections, biofilm development, and antibiotic resistance. The ESKAPE pathogens are a significant factor in these problems (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species). These pathogens, often known as hospital-acquired infections (HAIs), are common in hospital settings and present one of the most significant difficulties in treatment. The development of biofilms, in which the microbial cells adapt to a multicellular lifestyle by getting trapped inside the extracellular polymeric matrix, is a key biological concept in clinical contexts. For the creation of novel antimicrobial agents, as well as for the repurposing of currently accessible medications or pre-clinical substances and the broader use of combination therapies, it is essential to comprehend the process by which these bacteria build biofilms. The Pathomechanisms of these bacterial biofilm formations and alternate strategies to prevent biofilm formation in hospital management are highlighted in this review.
全球主要问题之一是医院感染、生物膜形成和抗生素耐药性的紧迫性。ESKAPE病原体是造成这些问题的一个重要因素(粪肠球菌、金黄色葡萄球菌、肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌和肠杆菌属)。这些病原体通常被称为医院获得性感染(HAI),在医院环境中很常见,是治疗中最严重的困难之一。生物膜的开发是临床上的一个关键生物学概念,在生物膜中,微生物细胞通过被困在细胞外聚合物基质中来适应多细胞的生活方式。为了创造新型抗菌剂,以及重新利用目前可获得的药物或临床前物质,以及更广泛地使用联合疗法,了解这些细菌构建生物膜的过程至关重要。这篇综述强调了这些细菌生物膜形成的病理机制以及在医院管理中预防生物膜生成的替代策略。
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引用次数: 0
Circumferential upper extremities burn, bilateral Dupuytren's disease and COVID-19 disease – an unfavorable triad: a case report 上肢周围烧伤、双侧Dupuytren's病和新冠肺炎病——一种不利的三联征:病例报告
Q4 Immunology and Microbiology Pub Date : 2022-12-31 DOI: 10.37897/rjid.2022.4.1
T. Neagu, Sabina Grama, M. Tiglis, I. Lascar
Upper extremities are frequently involved in fire burns due to the natural protective reflexes. The presence of bilateral Dupuytrenʼs disease and COVID-19 disease in patients with circumferential upper extremity burns can negatively impact the outcome, through severe contracture and a tendency to hypoxia or infections, which affects normal wound healing. Enzymatic debridement with a concentrate of proteolytic enzymes enriched in bromelain prevents compartment syndrome development in such patients, reduces blood loss, surgery duration, and appears to favor a more rapid recovery.
上肢由于天生的保护性反射而经常发生火灾烧伤。上肢周围烧伤患者双侧Dupuytren's病和新冠肺炎病的存在可能会通过严重的挛缩和缺氧或感染的趋势对结果产生负面影响,从而影响伤口的正常愈合。用富含菠萝蛋白酶的蛋白水解酶浓缩物进行酶清创术可以防止此类患者出现隔室综合征,减少失血,缩短手术时间,并有利于更快地康复。
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引用次数: 0
The management of neonatal herpes simplex virus infection in a small for gestational age neonate - Case report 新生儿单纯疱疹病毒感染的处理在一个小胎龄新生儿-病例报告
Q4 Immunology and Microbiology Pub Date : 2022-12-31 DOI: 10.37897/rjid.2022.4.2
Maria-Andreea Racean, L. Suciu, C. Mărginean
Neonatal herpes simplex virus infections are rare, normally acquired through vertical transmission in the peripartum period, usually manifesting before 14 days of life and being identified on the basis of history, clinical and laboratory evaluation. We present the case of a small for gestational age male infant born at 38 weeks gestational age with neonatal herpes simplex virus infection. The diagnosis was delayed because the attention was focused on an unidentified bacterial infection. In cases where a clinical picture suggestive of infection is described, with laboratory tests that support the diagnosis of infection, but with cultures that do not highlight bacterial or mycological agents, we must not forget about viral agents, specifically among those newborns from intrauterine growth restricted pregnancies. Neonatal HSV infections can be present even in the absence of herpetic vesicles in the newborn and even if the mother is asymptomatic.
新生儿单纯疱疹病毒感染是罕见的,通常在围产期通过垂直传播获得,通常在出生14天之前表现出来,并根据病史、临床和实验室评估来确定。我们提出的情况下,小胎龄男性婴儿出生在38周胎龄新生儿单纯疱疹病毒感染。由于注意力集中在一种不明细菌感染上,诊断被推迟了。如果描述了提示感染的临床症状,实验室检查支持感染的诊断,但培养不突出细菌或真菌学因子,我们不能忘记病毒因子,特别是在宫内生长受限妊娠的新生儿中。新生儿HSV感染可以存在,即使在新生儿没有疱疹囊泡,即使母亲是无症状的。
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引用次数: 0
Metastatic spinal lymphoma: A case report 转移性脊髓淋巴瘤1例报告
Q4 Immunology and Microbiology Pub Date : 2022-12-31 DOI: 10.37897/rjid.2022.4.4
R. Pinzon, Patrick Kurniawan Latumahina
Background. Metastatic spinal lymphoma is a rare case, especially with the initial clinical manifestation of back pain, which only occurs in less than 5% of patients. We report a case of an adult male with low back pain that was found to be metastatic spinal lymphoma, and this study is the first to report a case of metastatic spinal lymphoma with initial complaints of back pain. Case Presentation. A 66-year-old male presented with progressive lower extremity weakness since 2 weeks. The initial complaint was back pain since 2 months before admission. The patient had no history of previous trauma, history of hypertension, diabetes, or heart disease was also denied. The patient admitted that there was a weight loss in the last 2-3 months Radiologic examination of the lumbar spinal MRI (magnetic resonance imaging) without contrast was performed and showed an impression of bone metastasis at the corpus VL (lumbar vertebrae) 1-5, and paraspinal muscular spasm. Conclusion. We report rare case of metastatic spinal lymphoma, spinal lymphoma should be considered and monitored for non-specific clinical findings that resemble other possible causes.
背景。转移性脊髓淋巴瘤是一种罕见的病例,特别是最初的临床表现为背部疼痛,仅发生在不到5%的患者中。我们报告一例成年男性腰痛被发现是转移性脊柱淋巴瘤,本研究是第一个报告转移性脊柱淋巴瘤与背部疼痛的初始投诉的病例。案例演示。66岁男性,2周以来表现为进行性下肢无力。患者入院前2个月开始主诉背部疼痛。患者既往无外伤史、高血压史、糖尿病史、心脏病史也被否认。患者承认在过去的2-3个月体重减轻,对腰椎MRI(磁共振成像)进行了未经对比的放射检查,显示椎体VL(腰椎)1-5骨转移的印象,脊柱旁肌肉痉挛。结论。我们报告罕见的转移性脊髓淋巴瘤病例,脊髓淋巴瘤应考虑和监测非特异性临床表现,类似于其他可能的原因。
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引用次数: 0
The impact of ENT manifestation in COVID-19 patients 耳鼻喉科表现对新冠肺炎患者的影响
Q4 Immunology and Microbiology Pub Date : 2022-09-30 DOI: 10.37897/rjid.2022.3.4
Bogdan-Alexandru Georgescu, Bianca Neagu, Andrei Osman, Carmen Liana Mocanu, S. Rugina
The pandemic with the new coronavirus – SARS-CoV-2 – has caused extraordinary changes in our way of life. Infection with this virus has caused a huge number of diseases worldwide. After healing from this infection, many patients continued to show symptoms at a distance after the infection itself. SARS-CoV-2 virus infection is mainly manifested by symptoms related to the lower respiratory tract, such as fever, cough, dyspnea and chest pressure, which could rapidly evolve to acute respiratory distress syndrome (SARS). However, COVID-19 also causes various symptoms related to the upper respiratory tract, including nasal congestion, neck pain and olfactory dysfunction. We aim to review, analyze and compare small-looking research studies. Studies show what the changes in ENT are in COVID-19 pandemic disease, how these symptoms influence the course of the disease and how much immuno-depressed the patient this virus.it is found that this virus leaves a very precarious immune system and leaves serious consequences in terms of activating some pathologies and symptoms. We also intend to present an atypical case of a patient infected with the SARS-CoV-2 virus that showed a multitude of ENT manifestations both during the acute state and after healing.
新型冠状病毒SARS-CoV-2的大流行给我们的生活方式带来了巨大变化。这种病毒的感染在世界范围内引起了大量疾病。在这种感染愈合后,许多患者在感染后一段时间内继续表现出症状。SARS- cov -2病毒感染主要表现为发热、咳嗽、呼吸困难、胸压等与下呼吸道相关的症状,可迅速发展为急性呼吸窘迫综合征(SARS)。然而,COVID-19还会引起与上呼吸道相关的各种症状,包括鼻塞、颈部疼痛和嗅觉功能障碍。我们的目标是回顾、分析和比较小规模的研究。研究表明,在COVID-19大流行疾病中,耳鼻喉科的变化是什么,这些症状如何影响疾病的进程,以及这种病毒对患者的免疫抑制程度有多大。人们发现这种病毒使免疫系统变得非常不稳定,并在激活某些病理和症状方面造成严重后果。我们还打算提出一个感染SARS-CoV-2病毒的非典型病例,该病例在急性状态和愈合后均表现出多种耳鼻喉科表现。
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引用次数: 0
Waiting for the 7th wave of the pandemic: analysis of the COVID-19 cases from ”Victor Babes” Hospital, Craiova 等待第七波大流行:克拉约瓦“维克多宝贝”医院COVID-19病例分析
Q4 Immunology and Microbiology Pub Date : 2022-09-30 DOI: 10.37897/rjid.2022.3.3
L. Giubelan, F. Dumitrescu, I. Diaconescu, M. Forțofoiu, I. Cristina, Georgescu Ilona
COVID-19 is an ongoing pandemic and an analysis of the cases treated in ”Victor Babes” Hospital of Infectious Diseases and Pulmonology from Craiova between March 2020 and October 2022 has been performed.
新冠肺炎是一种持续的流行病,对2020年3月至2022年10月期间在克雷奥瓦“Victor Babes”传染病和肺病医院治疗的病例进行了分析。
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引用次数: 0
A new pandemic – new questions: postnatal care of infants born to mothers with suspected or confirmed COVID-19 新的大流行——新的问题:疑似或确诊COVID-19母亲所生婴儿的产后护理
Q4 Immunology and Microbiology Pub Date : 2022-09-30 DOI: 10.37897/rjid.2022.3.2
Lia Spoiala, Maura-Adelina Hincu, G. Zonda, Anda-Ioana Avasilcai, Cristina Gavrilovici, Vlad Dima, L. Păduraru
COVID-19 infection is primarily a community-acquired airborne respiratory infection, making pediatric and neonatal populations extremely vulnerable to the disease. Since the beginning of the coronavirus pandemic, many questions regarding mother and infant health have arisen, one of the most discussed issues being the management of infants born to mothers with suspected or confirmed COVID-19. Is it advisable to separate the child from the positive mother immediately after birth? What are the recommendations for breastfeeding? Are there any short and long-term follow-up indications or are there any possible long-term complications that we should take into account in those children? And not lastly, what are the most respectful and ethical measures both for mother and infant? We aim to analyze and compare the existing guidelines regarding the management of infants born to mothers with suspected or confirmed COVID-19 and to discuss the similarities and discrepancies between the available protocols.
COVID-19感染主要是一种社区获得性空气传播呼吸道感染,使儿科和新生儿极易感染该疾病。自冠状病毒大流行开始以来,出现了许多关于母婴健康的问题,其中讨论最多的问题之一是对疑似或确诊COVID-19母亲所生婴儿的管理。孩子出生后立即与阳性母亲分离是否可取?母乳喂养的建议是什么?这些儿童是否有短期和长期的随访指征或者是否有任何可能的长期并发症需要我们考虑?最后,对母亲和婴儿最尊重和最道德的措施是什么?我们的目的是分析和比较关于疑似或确诊COVID-19母亲所生婴儿管理的现有指南,并讨论现有方案之间的相似之处和差异。
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引用次数: 0
Sneathia infections and adverse perinatal outcomes – short communication Sneathia感染和不良围产期结果——简短沟通
Q4 Immunology and Microbiology Pub Date : 2022-09-30 DOI: 10.37897/rjid.2022.3.1
V. Varlas, Vlad Dima, R. Bors
The influence of the maternal vaginal microbiome in vaginal birth is an important factor in the pathogenesis of early-onset neonatal sepsis. The incidence of Sneathia infection is hard to assess due to the difficulty in its detection, as special culture conditions are required. The laboratory methods used in its detection are based on molecular analysis. This emergent, anaerobic agent, by ascending from the female genital tract, can colonize and infect the amniotic fluid, fetal membranes, and placenta. Chorioamnionitis, neonatal sepsis, stillbirth, spontaneous premature labor, and preterm prelabour rupture of the membrane are some of the adverse reactions that can be associated with the presence of Sneathia. In conclusion, Sneathia infection, although underestimated due to its virulence, represents an increased risk of maternal-fetal infections, with the risk of developing a series of neonatal complications. The detection and treatment of this infection will contribute to a decrease in neonatal morbidity and mortality.
母体阴道微生物组在阴道分娩中的影响是早发性新生儿败血症发病机制的一个重要因素。由于需要特殊的培养条件,Sneathia感染的发生率很难评估,因为它的检测很困难。用于检测它的实验室方法是基于分子分析的。这种从女性生殖道上升的新兴厌氧剂可以定植并感染羊水、胎膜和胎盘。绒毛膜羊膜炎、新生儿败血症、死产、自发性早产和早产胎膜破裂是可能与Sneathia相关的一些不良反应。总之,尽管由于Sneathia感染的毒力而被低估,但它代表着母婴感染的风险增加,并有发展一系列新生儿并发症的风险。这种感染的检测和治疗将有助于降低新生儿发病率和死亡率。
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引用次数: 0
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Revista Romana de Boli Infectioase
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